Cerebrospinal Fluid and Cerebral Blood Flows in Idiopathic Intracranial Hypertension

Olivier Balédent (1, 2) , Cyrille Capel (1, 2) , Marc Baroncini (3) , Catherine Gondry-Jouet (1, 2) , Roger Bouzerar (1) , Marek Czosnyka (4) , Zofia Czosnyka

1 CHU Amiens-Picardie
2 CHIMERE - CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516
3 JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837
4 Addenbrooke's Hospital

Objectives: Cerebrospinal fluid (CSF) and blood flows have a strong relationship during a cardiac cycle. Idiopathic intracranial hypertension (IIH) is a pathology that seems to present hemodynamic and hydrodynamic disturbance. The aim of this study was to establish CSF and blood interaction in IIH. Material and methods: We retrospectively studied cerebral hydrodynamic and hemodynamic flows by phase-contrast MRI (PCMRI) in 13 IIH subjects (according Dandy's criteria) and 16 controls. We analyzed arterial peak flow, pulsatility index, and resistive index in arterial and venous compartments (PFart, PIart, RIart, PFvein, PIvein, RIvein) and measured arteriovenous and CSF peak flow and stroke volume (PFav, SVVASC, PFCSF, SVCSF). Results: We found no significant difference between IIH and control groups in arterial and venous parameters. Arteriovenous flow analysis showed higher PFav and SVVASC in the IIH group than in the control group (respectively 369 +/- 27 mL/min and 286 +/- 47 mL/min, p = 0.02; and 1085 +/- 265 mu L/cardiac cycle and 801 +/- 226 mu L/cardiac cycle, p = 0.007). PFCSF and SVCSF were higher in the IIH group than in the control group (respectively 206 +/- 50 mL/min and 126.6 +/- 24.8 mL/min, p = 0.04; and 570 +/- 190 mu L/cardiac cycle and 430 +/- 100 mu L/cardiac cycle, p = 0.0007). Conclusion: Although no significant change was found in arterial and venous flows, we showed that a small phase shift of venous outflow might cause an increase in the arteriovenous pulsatility and an increasing brain expansion during the cardiac cycle. This arteriovenous flow increase would result in an increase of CSF flushing through the foramen magnum and an increased ICP.

Domaines: Sciences du Vivant [q-bio]

Olivier Balédent, Cyrille Capel, Marc Baroncini, Catherine Gondry-Jouet, Roger Bouzerar, et al.. Cerebrospinal Fluid and Cerebral Blood Flows in Idiopathic Intracranial Hypertension. INTRACRANIAL PRESSURE & NEUROMONITORING XVI, 2016, Cambridge, MA, US, Unknown Region. pp.237-241, ⟨10.1007/978-3-319-65798-1\_48⟩. ⟨hal-03599032⟩